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Asthma

Today asthma is viewed as a chronic (long-lasting) inflammatory disease of the airways. In those susceptible to asthma, this inflammation causes the airways to narrow periodically. This, in turn, produces wheezing and breathlessness, sometimes to the point where the patient gasps for air. Obstruction to air flow either stops spontaneously or responds to a wide range of treatments, but continuing inflammation makes the airways hyper-responsive to stimuli such as cold air, exercise, dust mites, pollutants in the air, and even stress and anxiety.

Between 1982-92, the numbers of those with asthma rose by 42%. Not only is asthma becoming more frequent, but it also is a more severe disease than before, despite modern drug treatments.

The changes that take place in the lungs of asthmatic persons makes the airways (the bronchi and the smaller bronchioles) hyper-reactive to many different types of stimuli which do not affect healthy lungs. In an asthma attack, the muscle tissue in the walls of the bronchi go into spasm and the cells lining the airways swell and secrete mucus into the air spaces. Both these actions cause the bronchi to become narrowed (bronchoconstriction). As a result, an asthmatic person has to make a much greater effort to breathe in air and to expel it.

Cells in the bronchial walls, called mast cells, release certain substances that cause the bronchial muscle to contract and to stimulate mucus formation. These substances, which include histamine and a group of chemicals called leukotrienes, also bring white blood cells into the area, which is a key part of the inflammatory response. Many patients with asthma are prone to react to such "foreign" substances as pollen, house dust mites or animal dander; these are called allergens. On the other hand, asthma affects many patients who are not "allergic" in this way.

Asthma usually begins in childhood or adolescence, but it also may first appear during adult years. While the symptoms may be similar, certain important aspects of asthma are different in children and adults.

Child-Onset Asthma

When asthma does begin in childhood, it often does so in a child who is likely, for genetic reasons, to become sensitised to common "allergens" in the environment (an atopic person). When these children are exposed to house-dust mites, animal proteins, fungi or other potential allergens they produce a type of antibody that is intended to engulf and destroy the foreign material. This has the effect of making the airway cells sensitive to particular materials. Further exposure can lead rapidly to an asthmatic response. This condition of atopy is present in at least one-third and as many as half of the general population. When an infant or young child wheezes during viral infections, the presence of allergy (in the child itself or in a close relative) is a clue that asthma may well continue throughout childhood.

Adult-Onset Asthma

Allergenic materials may also play a role when adults become asthmatic. Asthma can start at any age and in a wide variety of situations. Many adults who are not allergic do have such conditions as sinusitis or nasal polyps, or they may be sensitive to aspirin and related drugs. Another major source of adult asthma is exposure at work to animal products, certain forms of plastic, wood dust, or metals.

Research has shown that people who ate the most fruit and vegetables have the healthiest lung function. Vitamins C and E are believed to help reduce the severity of the inflammatory response in the lungs of people with asthma. A diet that includes a high level of nutrients can also boost the immune system and help ward off colds and flu, both of which are common asthma-triggers.

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The University of Maryland Medical Center, in relation to asthma, advises:

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care practitioner.

Boswellia (Boswellia serrata, 3 mg three times per day) -- Boswellia (also known as Salai guggal) is an herb commonly used in Ayurvedic medicine, a traditional Indian system of health care. In one double-blind, placebo-controlled study, people who took boswellia had fewer attacks and improved lung function. Boswellia may help leukotreine modifiers work better. However, more research is needed. People who take medication to lower their cholesterol, or people who take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) should talk to their doctor before taking boswellia.

Coleus forskohlii -- Coleus forskohlii, for forskolin, is another herb used in Ayurvedic medicine to treat asthma. A few preliminary studies suggest that inhaled forskolin powder seemed to relieve symptoms, but more research is needed to know for sure. People who have diabetes or thyroid conditions should not take forskolin. If you take blood thinners such as warfarin (Coumadin), taking forskolin may increase your risk of bleeding. Pregnant women should not take forskolin. Forskolin interacts with calcium channel blockers such as verapamil (Calan, Verelan), nifedipine (Procardia), and diltiazem (Cardizem, Dilacor) and with nitroglycerin (Nitro-Bid, Nitro-Dur, and Nitrostat) and isosorbide (Imdur, Isordil, and Sorbitrate).

Tylophora (Tylophora indica, 250 mg one to three times per day) -- Tylophora has also been used historically to treat asthma. Some modern scientific studies show that it can help reduce symptoms, but the studies were of poor quality. More research is needed. Tylophora may cause serious side effects at high doses, so talk to your doctor before taking it. Do not take tylophora if you are pregnant, have diabetes, high blood pressure, or congestive heart failure.

Pycnogenol (Pinus pinaster, 1 mg per pound of body weight, up to 200 mg) -- A 2002 review of studies on a standardized extract from French maritime pine bark, called pycnogenol, suggests that it may reduce symptoms and improve lung function in people with asthma. Another study found that children with asthma who took pycnogenol along with prescription asthma medications had fewer symptoms and needed fewer rescue medications. Do not use pycnogenol if you have diabetes or take medication for high blood pressure. If you take blood thinners such as warfarin (Coumadin) or aspirin, taking pycnogenol may increase your risk of bleeding.

Saiboku-to -- In three preliminary studies, a traditional Japanese herbal mixture called Saiboku-to has helped reduce symptoms and allowed study participants to reduce doses of corticosteroids. In test tubes, Saiboku-to has shown anti-inflammatory effects. Saiboku-to contains several herbs, including Asian ginseng (Panax ginseng), Chinese skullcap (Baikal scutellaria), licorice (Glycyrrhiza glabra), and ginger (Zingiber officinale). These herbs can interact with other medications, so talk to your healthcare provider before taking Saiboku-to.